Unnecessary Psychotropic Medication Prescribed for Dementia
Penalty
Summary
A resident with a diagnosis of dementia without behavioral disturbances was prescribed sertraline, a psychotropic medication approved for the treatment of depression, according to a physician's order. The medication administration record showed that the resident received sertraline 25 mg daily for 25 consecutive days. The facility's policy required that the indication for any psychotropic medication be thoroughly documented in the clinical record, including an appropriate supporting diagnosis and identification of behavioral symptoms being treated. However, the documentation indicated that sertraline was prescribed for dementia, and staff interviews revealed uncertainty regarding the specific symptoms being treated and whether sertraline was appropriate for dementia. The contracted pharmacist confirmed that sertraline is not approved for the treatment of dementia and stated an effort was being made to avoid psychotropic use in residents with dementia. The LPN interviewed was unable to specify the symptom for which the medication was prescribed and was unaware of its approval status for dementia. The nurse practitioner acknowledged that the resident was taking an antidepressant for dementia, which is not an approved use, but also noted the resident had signs of depression and was seeing a behavioral health group. The DON was also unsure if antidepressants or psychotropic medications were approved for dementia treatment.